title: A population-based study of overweight and obesity in expectant parents: socio-demographic patterns and within-couple associations.
abstract: BACKGROUND
  Overweight and obesity in pregnancy increase the risk of several adverse pregnancy outcomes. However, both mothers' and fathers' health play an important role for long-term health outcomes in offspring. While aspects of health and lifestyle of pregnant women have been reported, the health of expectant fathers and correlations of health variables within couples have received less attention. This study aimed to explore the prevalence and socio-demographic patterns of overweight and obesity in Swedish expectant parents, and to assess within-couple associations.
  
  
  METHODS
  This population-based, cross-sectional study investigated self-reported data from 4352 pregnant women and 3949 expectant fathers, comprising 3356 identified couples. Data were collected in antenatal care clinics between January 2008 and December 2011. Descriptive, correlation and logistic regression analyses were performed.
  
  
  RESULTS
  The self-reported prevalence of overweight (BMI 25.0-29.99) and obesity (BMI ≥ 30.0) was 29% among women (pre-pregnancy) and 53% among expectant fathers. In a majority of couples (62%), at least one partner was overweight or obese. The odds of being overweight or obese increased relative to partner's overweight or obesity, and women's odds of being obese were more than six times higher if their partners were also obese in comparison with women whose partners were of normal weight (OR 6.2, CI 4.2-9.3). A socio-demographic gradient was found in both genders in relation to education, occupation and area of residence, with higher odds of being obese further down the social ladder. The cumulative influence of these factors showed a substantial increase in the odds of obesity for the least compared to the most privileged (OR 6.5, CI 3.6-11.8).
  
  
  CONCLUSIONS
  The prevalence of overweight and obesity in expectant parents was high, with a clear social gradient, and a minority of couples reported both partners with a healthy weight at the onset of pregnancy. Partner influence on health and health behaviours, and the role both mothers and fathers play in health outcomes of their offspring, underpin the need for a more holistic and gender inclusive approach to the delivery of pregnancy care and postnatal and child health services, with active measures employed to involve fathers.
authors.affiliation: Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, SE 901 87 Umeå, Sweden. kristina.edvardsson@obgyn.umu.se.
authors.forename: Kristina
authors.initials: K
authors.lastname: Edvardsson
authors.forename: Marie
authors.initials: M
authors.lastname: Lindkvist
authors.forename: Eva
authors.initials: E
authors.lastname: Eurenius
authors.forename: Ingrid
authors.initials: I
authors.lastname: Mogren
authors.forename: Rhonda
authors.initials: R
authors.lastname: Small
authors.forename: Anneli
authors.initials: A
authors.lastname: Ivarsson
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002648:Child; D002662:Child Health Services; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D009765:Obesity / Q000453:epidemiology*; D050177:Overweight / Q000453:epidemiology; D010290:Parents; D011247:Pregnancy; D011256:Pregnancy Outcome; D015995:Prevalence; D057566:Self Report; D012923:Social Class; D012959:Socioeconomic Factors; D055815:Young Adult